title: The vulnerable coronary plaque: update on imaging technologies.
abstract: Several studies have been carried out on vulnerable plaque as the main culprit for ischaemic cardiac events. Historically, the most important diagnostic technique for studying coronary atherosclerotic disease was to determine the residual luminal diameter by angiographic measurement of the stenosis. However, it has become clear that vulnerable plaque rupture as well as thrombosis, rather than stenosis, triggers most acute ischaemic events and that the quantification of risk based merely on severity of the arterial stenosis is not sufficient. In the last decades, substantial progresses have been made on optimisation of techniques detecting the arterial wall morphology, plaque composition and inflammation. To date, the use of a single technique is not recommended to precisely identify the progression of the atherosclerotic process in human beings. In contrast, the integration of data that can be derived from multiple methods might improve our knowledge about plaque destabilisation. The aim of this narrative review is to update evidence on the accuracy of the currently available non-invasive and invasive imaging techniques in identifying components and morphologic characteristics associated with coronary plaque vulnerability.
authors.affiliation: Fabrizio Montecucco, MD, PhD, Division of Cardiology, Faculty of Medicine, Geneva University Hospital, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland, Tel.: +41 22 372 71 92, Fax: +41 22 382 72 45, E-mail: fabrizio.montecucco@unige.ch.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Rosa
authors.forename: Matteo
authors.initials: M
authors.lastname: Bauckneht
authors.forename: Giovanni
authors.initials: G
authors.lastname: Masoero
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.forename: Alessandra
authors.initials: A
authors.lastname: Quercioli
authors.forename: Sara
authors.initials: S
authors.lastname: Seitun
authors.forename: Manrico
authors.initials: M
authors.lastname: Balbi
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
authors.forename: Antonello
authors.initials: A
authors.lastname: Parodi
authors.forename: Alessio
authors.initials: A
authors.lastname: Nencioni
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vuilleumier
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
mesh_terms: D000818:Animals; D001019:Aortic Rupture / Q000209:etiology / Q000517:prevention & control*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis*
keywords: Vulnerable plaque; atherosclerosis; coronary arteries; imaging; nuclear medicine